Abstract
We reported a case of dermatomyositis (DM) with liver disturbance in a 50-year-old Japanese female. She presented with fever, muscle weakness, and typical DM rashes. On clinical and serological examinations, the liver impairment was initially diagnosed as probable autoimmune hepatitis, which was denied by a histological study despite positive anti-liver–kidney microsome-1 antibody. Finally, she was diagnosed as having DM with “liver disease associated with rheumatoid diseases”, and treatment with oral prednisone (40 mg/day) achieved normalization of liver and muscle enzyme levels as well as improvement of symptoms associated with DM. Liver involvement in patients with polymyositis (PM)/DM has not been well described and is considered to be uncommon. Full clarification of the etiology of liver impairment with a histological examination in collagen diseases including PM/DM is useful to determine the proper dose of corticosteroids for the treatment of collagen diseases and their liver complications.
This is a preview of subscription content, log in via an institution to check access.
References
Kojima H, Uemura M, Sakurai S, Ann T, Ishii Y, Imazu H, Yoshikawa M, Ichijima K, Fukui H (2002) Clinical features of liver disturbance in rheumatoid diseases: clinicopathological study with special reference to the cause of liver disturbance. J Gastroenterol 37:617–625
Matsumoto T, Kobayashi S, Shimizu H, Nakajima M, Watanabe S, Kitami N, Sato N, Abe H, Aoki Y, Hoshi T, Hashimoto H (2000) The liver in collagen diseases: pathologic study of 160 cases with particular reference to hepatic arteritis, primary biliary cirrhosis, autoimmune hepatitis and nodular regenerative hyperplasia of the liver. Liver 20:366–373
Marie I, Levesque H, Courtois H, François A, Riachi G (2000) Polymyositis, cranial neuropathy, autoimmune hepatitis, and hepatitis C. Ann Rheum Dis 59:839–840
Alvarez F, Berg PA, Bianchi FB et al (1999) International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol 31:929–938
Hennes EM, Zeniya M, Czaja AJ et al (2008) International Autoimmune Hepatitis Group. Simplified criteria for the diagnosis of autoimmune hepatitis. Hepatology 48:169–176
Abraham S, Begum S, Isenberg D (2004) Hepatic manifestations of autoimmune rheumatic diseases. Ann Rheum Dis 63:123–129
Disclosures
None
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Noda, S., Asano, Y., Tamaki, Z. et al. A case of dermatomyositis with “liver disease associated with rheumatoid diseases” positive for anti-liver–kidney microsome-1 antibody. Clin Rheumatol 29, 941–943 (2010). https://doi.org/10.1007/s10067-010-1397-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-010-1397-3